"Nice finger, Mom!"

When Maria was 5 or 6 months old, we were reading a book on my lap. I tried to direct her attention to a dog on a page by pointing at it. I didn't touch the page, but just held out my finger in front of it, pointing toward the dog. Maria looked at my finger, grabbed it with her hand and started chewing on it. "Nice finger, mom!" seemed to be her reaction to my pointing. Fast forward a year. Again, we were reading a book with a picture of a dog. This time the dog was hard to see (James Herriot's The Market Square Dog). I pointed toward the dog and said "Look! What's there?" Maria looked at the page and then announced gleefully "A doggie!"

So what changed in that year? Why did she notice only my finger at 6 months but the picture at 18 months? Joint attention. Joint attention is often discussed in the developmental literature, but rarely included in parenting books or magazines. This is a shame, because joint attention turns out to be a crucial, pivotal skill for both language and social development. It's what keeps you on the same page as everyone else when you are interacting with them.

Joint attention is just what it sounds like: two people paying attention to the same thing. It sounds remarkably simple. And yet, it turns out to be more complex than just paying attention. Joint attention requires the child to figure out what the adults (or other children) are paying attention to. It requires them to recognize that other people might be attending to something different than they are. It requires the child to realize that they too can get and direct someone's attention. These are concepts that develop slowly over the first year and half or two of life.

As with most things, joint attention begins with 'baby steps', or in this case baby looks. At 6 months Maria was just beginning to get the skills necessary for joint attention. By 18 months, she had become an old pro in that area.

Even children under 3 months will look into the eyes of someone who is looking at them, albeit if it's briefly in the beginning. As they get closer to 3 or 4 months, they will spend time looking in your eyes and gazing at you. And during this time, they also engage in what look like 'conversations' with you. If you talk to them, the baby will listen intently. When you pause, the baby will respond. Sometimes verbally, sometimes by smiling, sometimes by looking you in the eye, sometimes by waving a hand. This turn-taking is a baby-step in how to have a conversation and some aruge that it forms the the foundations for real conversations later.

Between 6 and 12 months is when the skills for joint attention really take off. At 6 months, infants are much better at looking you in the eye and interacting than they were even 3 months earlier. This is the age where they begin to really delight in peek-a-boo, patty cake and other games. And at 6 months, infants can sometimes figure out which direction an adult is looking toward by following how the adult turns their head. But, they aren't very good at figuring out what the adults are looking at. They will generally stop at the first interesting object they see. Hence Maria's grabbing my finger. She was orienting in the same direction that I was, but she stopped at the first cool thing she saw: my finger! At 9 months, infants are better at identifying where an adult is looking. They can follow not only the head, but another person's eye gaze to figure out where they are looking. But again, they tend to stop with the first interesting object, and aren't very reliable in figuring out what an adult is attending too. But by 12 months, infants are not only looking in the same direction, they're usually pretty good at figuring out what an adult is looking at. By 18 months, they've go it mastered. Instead of noticing just the finger, they follow the direction of the finger.

To be truly social communicators, infants also need to be able to do more than figure out what another person is interested in. They also need to be able to attract and direct someone else's attention. Thus, there's a second set of joint attention skills that a child needs to acquire. And, this set has two important functions, requesting something and commenting on something. Both are important for social development.

If an infant wants a toy, but cannot reach it, at 6 months, they will most likely just reach for it, and complain loudly if they can't get it. By 9 months or so, they will reach for it, but also look at the parent for help. By 12 months, they've often become masters at this - reaching for or pointing to something, looking at the parent, looking back at the object, and then checking in with the parent to make sure they're following their gaze. And they'll keep doing it until they get what they want or their parents move them! This is the level that indicates the child is truly trying to communicate an intention to the adult.

Just as important, though less recognized, are the gestures and vocalizations that are simply meant to draw a parents' attention to an object or event. This type of joint attention is more conversational. It has the same steps as the requests, but without the demand for the item. So, at 6 months, a child may reach toward an object and babble, but not really connect it with the parent. By 12 months however, a child may well point to something, like a picture in a book, a cool truck on the street or Mommy walking in the door, look at the other person, wait for the response and look back. They'll also keep 'commenting' until the adult responds. This kind of joint attention is the beginning step in a real conversation.

But why is joint attention so important?

If joint attention doesn't develop, a child often doesn't develop the language or social skills needed to interact with others. Language is a social act. It involves learning and understanding social interactions, and having social motivations. Joint attention cues a child into these social interactions and makes language learning possible. Without these, a child's language and social cognition cannot develop.

Indeed, one of the major symptoms of Autism is a lack of joint attention. Children with Autism are very often delayed in joint attention. They're delayed in following other people's gazes or pointing, and they're delayed in their own pointing and commenting. They often learn to request things, but they have difficulty just 'commenting' on things. Their communication is functional, but not conversational.

And it turns out that the ability to initiate or respond to this conversational kind of attention is what matters most for learning social interactions and language. The better children are able to use these behaviors, the more social and language skills they develop. Thus, joint attention is a milestone that all parents should know about and watch for. It's as important as those first steps and that first smile!